Research Request Form               

      One inquiry per letter

      Juniper Branch of Family Finders
      21 SE “D” Street
      Madras, OR 97741
      541 475-9745
      jbff@madras.net

      Your Name: _______________________________________                 Date____________      

      Your Address: Street_________________________________________________                      

      City___________________________                State_________     Zip____________________

      Phone Number:__________________ Email_______________________________                    

      Name of Person or Subject of your inquiry__________________________________________

      Dates of residence or occurrence in Jefferson County (approx. if exact date unknown)

      _________________________________________                                                     ________  

      Place of  residence: Town______________________ City_______________________________
      County___________________________Other ________________________________________

      Exact (or approx) year of birth ______________________ year of death ______________  ____

      Please state briefly what information you need: _______________________________________

      _____________________________________________________________________  _____    

      Cite any sources you have already checked__________________________________________

      _____________________________________________________________________________

      Please remit $10.00 for the first hour of research with this request form.

      Note that information gathered may be kept on file and made available to other researchers

      Please allow 2-4 weeks 

       

      Signature____________________________________________________________

      *FOR OFFICE USE ONLY

      Date received & logged by                Assigned to             Date completed           Comments

      _________________________________________________________________________